Provider Demographics
NPI:1053081521
Name:J&M OPTICS LLC
Entity Type:Organization
Organization Name:J&M OPTICS LLC
Other - Org Name:MY EYELAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-612-4531
Mailing Address - Street 1:6415 ATHENEE LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0369
Mailing Address - Country:US
Mailing Address - Phone:347-610-6818
Mailing Address - Fax:561-828-8367
Practice Address - Street 1:7707 N MACARTHUR BLVD STE 130
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7532
Practice Address - Country:US
Practice Address - Phone:347-610-6818
Practice Address - Fax:561-828-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier